1. Individualized positive end‐expiratory pressure with and without recruitment maneuvers in obese patients during bariatric surgery
- Author
-
Zhi‐Yao Wang, Shan‐Shan Ye, Yu Fan, Cheng‐Ye Shi, Hai‐Fu Wu, Chang‐Hong Miao, and Di Zhou
- Subjects
electrical impedance tomography ,laparoscope bariatric surgery ,obese patients ,recruitment maneuver ,Medicine (General) ,R5-920 - Abstract
Abstract This study aimed to determine whether regular recruitment maneuvers (RMs) are essential for obese patients (OPs) undergoing elective laparoscopic bariatric surgery (LBS) during intraoperative ventilation with individualized positive end‐expiratory pressure (PEEP). Patients were randomly assigned to two arms: the RM + PEEP−EIT arm consisted of individualized PEEP titrated by electrical impedance tomography (EIT) with two regular RMs and the PEEP−EIT arm consisted of individualized PEEP titrated by EIT without additional RMs. For these two arms together, EIT‐guided PEEP varied among individuals. The partial pressure of oxygen in arterial blood to fractional inspired oxygen (PaO2/FiO2) ratio in the RM + PEEP−EIT arm was higher than that in the PEEP−EIT arm at 1 h after pneumoperitoneum (p = 0.024) and at the end of surgery (p = 0.035). There was no great difference in the PaO2/FiO2 ratio between these two arms when measured 5 min prior to postanesthesia care unit (PACU) departure and on postoperative day 1. Compared with the PEEP−EIT arm, patients in the RM + PEEP−EIT arm had significantly higher intraoperative dynamic respiratory system compliance (p
- Published
- 2022
- Full Text
- View/download PDF